Passage of loose, unformed stools
• Abdominal pain and cramping
• At least three loose, liquid stools per day
• Hyperactive bowel sounds
• Psychological: anxiety, high stress levels
• Physiological: malabsorption, infectious processes, irritation, para-
• Situational: adverse effects of medications, alcohol abuse,
toxins, laxative abuse, contaminants, radiation, tube feedings,
ASSESSMENT FOCUS (Refer to comprehensive assessment parameters.)
• Fluid and electrolytes
The patient will
• Have less or no diarrheal episodes.
• Resume usual bowel pattern.
• Maintain weight and ﬂuid and electrolyte balance.
• Keep skin clean and free from irritation or ulcerations.
• Explain causative factors and preventive measures.
• Discuss relationship of stress and anxiety to episodes of diarrhea.
• State plans to use stress-reduction techniques (specify).
• Demonstrate ability to use at least one stress-reduction technique.
SUGGESTED NOC OUTCOMES
Bowel Continence; Hydration; Symptom Control
INTERVENTIONS AND RATIONALES
Determine: Monitor and record frequency and characteristics of
stools to monitor treatment effectiveness.
Identify stressors and help the patient solve problems to provide
more realistic approach to care.
Monitor perianal skin for irritation and ulceration; treat according
to established protocol to promote comfort, skin integrity, and free-
dom from infection.
Perform: Administer antidiarrheal medications, as ordered, to
improve body function, promote comfort, and balance body ﬂuids,
salts, and acid–base levels. Monitor and report effectiveness of
Provide replacement ﬂuids and electrolytes as prescribed. Maintain
accurate records to ensure balanced ﬂuid intake and output.
Inform: Teach patient to use relaxation techniques to reduce muscle
tension and nervousness; recognize and reduce intake of diarrhea-
producing foods or substances (such as dairy products and fruit) to
reduce residual waste matter and decrease intestinal irritation.
Instruct patient to record diarrheal episodes and report them to
staff to promote comfort and maintain effective patient–staff
Attend: Encourage patient to ventilate stresses and anxiety; release of
pent-up emotions can temporarily relieve emotional distress.
Encourage and assist patient to practice relaxation techniques to
reduce tension and promote self-knowledge and growth.
Spend at least 10 min with patient twice daily to discuss stress-
reducing techniques; this can help patient pinpoint speciﬁc fears.
Manage: Consult with dietician to determine foods that may be
related to diarrheal episodes.
SUGGESTED NIC INTERVENTIONS
Diarrhea Management; Nutrition Management; Skin Surveillance;
Fletcher, P. C., & Schneider, M. A. (2006, September–October). Is there any
food I can eat? Living with inﬂammatory bowel disease and/or irritable
bowel syndrome. Clinical Nurse Specialist, 20(5), 241–247.